- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $5,463.36 / $13,841.56
| Facility | | $1,506.15 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,896.99 / $5,281.43 / $9,914.59
| Facility | | $3,896.99 | $5,281.43 | $9,914.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $348.03 / $591.65 / $3,227.00
| Facility | | $348.03 | $591.65 | $3,227.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $662.29 / $881.12 / $2,979.56
| Facility | | $662.29 | $881.12 | $2,979.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.00 / $3,227.00 / $6,169.00
| Facility | | $1,775.00 | $3,227.00 | $6,169.00 |